Psychological distress as a central mediator of suicidal ideation among Brazilian veterinarians: A study of occupational stress, compassion fatigue, coping strategies, and workplace environment using structural equation modeling

Background and Aim: Veterinarians experience disproportionately high levels of psychological distress and suicidal ideation compared with other professional groups. Occupational stress (OS), compassion fatigue, workplace environment (WE), and coping strategies have been identified as relevant risk or protective factors; however, their interrelationships remain insufficiently explored, particularly in Brazil. This study aimed to examine the direct and indirect pathways linking occupational psychosocial factors to suicidal ideation among Brazilian veterinarians working in companion-animal practice, with psychological distress conceptualized as a central mediating mechanism. Materials and Methods: A nationwide cross-sectional survey was conducted between June and July 2022 involving 1,472 veterinarians exclusively engaged in small animal practice in Brazil. Participants completed validated self-report measures assessing psychological distress (Kessler-6), suicidal ideation, coping strategies, compassion fatigue, OS, and WE. Data were analyzed using partial least squares structural equation modeling (PLS-SEM) with 5,000 bootstrap resamples. Direct, indirect, and mediating effects were estimated, and model fit, reliability, and validity were assessed. Ethical approval was obtained from the Research Ethics Committee of Inspirar College (protocol no. 31645220.4.0000.5594). Results: Psychological distress emerged as the strongest predictor of suicidal ideation (β = 0.40; p < 0.001), explaining 20.6% of its variance. OS showed a substantial positive association with psychological distress (β = 0.47; p < 0.001), followed by compassion fatigue (β = 0.15; p < 0.001) and WE (β = 0.07; p = 0.028). Coping strategies exerted a significant protective effect on psychological distress (β = −0.26; p < 0.001) and suicidal ideation (β = −0.08; p = 0.013). Indirect effects confirmed that psychological distress mediated the associations between OS, compassion fatigue, WE, and suicidal ideation. Younger age and female gender were indirectly associated with higher suicidal ideation through increased psychological distress. Conclusion: Psychological distress plays a central mediating role in the relationship between occupational psychosocial factors and suicidal ideation among Brazilian veterinarians. Interventions targeting OS reduction, emotional support, and the promotion of adaptive coping strategies may substantially mitigate suicide risk in veterinary clinical practice. Keywords: compassion fatigue, coping strategies, occupational stress, psychological distress, small animal veterinarians, structural equation modeling, suicidal ideation, workplace environment.